| NPI | 1669943619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 7934) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 7934) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 7934) | |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2019-01-30 |